The FFC recommends that the Department extends its ongoing efforts to reform the health fiscal frameworks by taking into account the burden of disease giving rise to budget pressures; develop norms and standards for funding and delivery on health; as well as consolidate the conditional grants into a conditional grant at the same time address underlying drivers of poor performance and effect improvement in accountability. Of critical importance, the department needs to address challenges related to institutional failure and inconsistent provincial budget performance which consequently impacts on the Department's performance.